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Publisher: John Wiley and Sons   (Total: 1577 journals)

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Showing 1 - 200 of 1577 Journals sorted alphabetically
Abacus     Hybrid Journal   (Followers: 12, SJR: 0.48, h-index: 22)
About Campus     Hybrid Journal   (Followers: 5)
Academic Emergency Medicine     Hybrid Journal   (Followers: 61, SJR: 1.385, h-index: 91)
Accounting & Finance     Hybrid Journal   (Followers: 46, SJR: 0.547, h-index: 30)
ACEP NOW     Free   (Followers: 1)
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 49, SJR: 1.02, h-index: 88)
Acta Archaeologica     Hybrid Journal   (Followers: 144, SJR: 0.101, h-index: 9)
Acta Geologica Sinica (English Edition)     Hybrid Journal   (Followers: 3, SJR: 0.552, h-index: 41)
Acta Neurologica Scandinavica     Hybrid Journal   (Followers: 5, SJR: 1.203, h-index: 74)
Acta Obstetricia et Gynecologica Scandinavica     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 81)
Acta Ophthalmologica     Hybrid Journal   (Followers: 5, SJR: 0.112, h-index: 1)
Acta Paediatrica     Hybrid Journal   (Followers: 56, SJR: 0.794, h-index: 88)
Acta Physiologica     Hybrid Journal   (Followers: 6, SJR: 1.69, h-index: 88)
Acta Polymerica     Hybrid Journal   (Followers: 9)
Acta Psychiatrica Scandinavica     Hybrid Journal   (Followers: 35, SJR: 2.518, h-index: 113)
Acta Zoologica     Hybrid Journal   (Followers: 6, SJR: 0.459, h-index: 29)
Acute Medicine & Surgery     Hybrid Journal   (Followers: 3)
Addiction     Hybrid Journal   (Followers: 33, SJR: 2.086, h-index: 143)
Addiction Biology     Hybrid Journal   (Followers: 12, SJR: 2.091, h-index: 57)
Adultspan J.     Hybrid Journal   (SJR: 0.127, h-index: 4)
Advanced Energy Materials     Hybrid Journal   (Followers: 24, SJR: 6.411, h-index: 86)
Advanced Engineering Materials     Hybrid Journal   (Followers: 26, SJR: 0.81, h-index: 81)
Advanced Functional Materials     Hybrid Journal   (Followers: 50, SJR: 5.21, h-index: 203)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 13, SJR: 0.232, h-index: 7)
Advanced Materials     Hybrid Journal   (Followers: 254, SJR: 9.021, h-index: 345)
Advanced Materials Interfaces     Hybrid Journal   (Followers: 6, SJR: 1.177, h-index: 10)
Advanced Optical Materials     Hybrid Journal   (Followers: 5, SJR: 2.488, h-index: 21)
Advanced Science     Open Access   (Followers: 5)
Advanced Synthesis & Catalysis     Hybrid Journal   (Followers: 17, SJR: 2.729, h-index: 121)
Advances in Polymer Technology     Hybrid Journal   (Followers: 13, SJR: 0.344, h-index: 31)
Africa Confidential     Hybrid Journal   (Followers: 19)
Africa Research Bulletin: Economic, Financial and Technical Series     Hybrid Journal   (Followers: 12)
Africa Research Bulletin: Political, Social and Cultural Series     Hybrid Journal   (Followers: 9)
African Development Review     Hybrid Journal   (Followers: 35, SJR: 0.275, h-index: 17)
African J. of Ecology     Hybrid Journal   (Followers: 15, SJR: 0.477, h-index: 39)
Aggressive Behavior     Hybrid Journal   (Followers: 15, SJR: 1.391, h-index: 66)
Aging Cell     Open Access   (Followers: 10, SJR: 4.374, h-index: 95)
Agribusiness : an Intl. J.     Hybrid Journal   (Followers: 6, SJR: 0.627, h-index: 14)
Agricultural and Forest Entomology     Hybrid Journal   (Followers: 14, SJR: 0.925, h-index: 43)
Agricultural Economics     Hybrid Journal   (Followers: 44, SJR: 1.099, h-index: 51)
AIChE J.     Hybrid Journal   (Followers: 30, SJR: 1.122, h-index: 120)
Alcoholism and Drug Abuse Weekly     Hybrid Journal   (Followers: 7)
Alcoholism Clinical and Experimental Research     Hybrid Journal   (Followers: 7, SJR: 1.416, h-index: 125)
Alimentary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 34, SJR: 2.833, h-index: 138)
Alimentary Pharmacology & Therapeutics Symposium Series     Hybrid Journal   (Followers: 3)
Allergy     Hybrid Journal   (Followers: 49, SJR: 3.048, h-index: 129)
Alternatives to the High Cost of Litigation     Hybrid Journal   (Followers: 3)
American Anthropologist     Hybrid Journal   (Followers: 134, SJR: 0.951, h-index: 61)
American Business Law J.     Hybrid Journal   (Followers: 24, SJR: 0.205, h-index: 17)
American Ethnologist     Hybrid Journal   (Followers: 91, SJR: 2.325, h-index: 51)
American J. of Economics and Sociology     Hybrid Journal   (Followers: 27, SJR: 0.211, h-index: 26)
American J. of Hematology     Hybrid Journal   (Followers: 31, SJR: 1.761, h-index: 77)
American J. of Human Biology     Hybrid Journal   (Followers: 12, SJR: 1.018, h-index: 58)
American J. of Industrial Medicine     Hybrid Journal   (Followers: 16, SJR: 0.993, h-index: 85)
American J. of Medical Genetics Part A     Hybrid Journal   (Followers: 15, SJR: 1.115, h-index: 61)
American J. of Medical Genetics Part B: Neuropsychiatric Genetics     Hybrid Journal   (Followers: 3, SJR: 1.771, h-index: 107)
American J. of Medical Genetics Part C: Seminars in Medical Genetics     Partially Free   (Followers: 5, SJR: 2.315, h-index: 79)
American J. of Physical Anthropology     Hybrid Journal   (Followers: 36, SJR: 1.41, h-index: 88)
American J. of Political Science     Hybrid Journal   (Followers: 254, SJR: 5.101, h-index: 114)
American J. of Primatology     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 63)
American J. of Reproductive Immunology     Hybrid Journal   (Followers: 3, SJR: 1.347, h-index: 75)
American J. of Transplantation     Hybrid Journal   (Followers: 16, SJR: 2.792, h-index: 140)
American J. on Addictions     Hybrid Journal   (Followers: 9, SJR: 0.843, h-index: 57)
Anaesthesia     Hybrid Journal   (Followers: 128, SJR: 1.404, h-index: 88)
Analyses of Social Issues and Public Policy     Hybrid Journal   (Followers: 10, SJR: 0.397, h-index: 18)
Analytic Philosophy     Hybrid Journal   (Followers: 16)
Anatomia, Histologia, Embryologia: J. of Veterinary Medicine Series C     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 27)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1, SJR: 0.633, h-index: 24)
Andrologia     Hybrid Journal   (Followers: 2, SJR: 0.528, h-index: 45)
Andrology     Hybrid Journal   (Followers: 2, SJR: 0.979, h-index: 14)
Angewandte Chemie     Hybrid Journal   (Followers: 160)
Angewandte Chemie Intl. Edition     Hybrid Journal   (Followers: 213, SJR: 6.229, h-index: 397)
Animal Conservation     Hybrid Journal   (Followers: 36, SJR: 1.576, h-index: 62)
Animal Genetics     Hybrid Journal   (Followers: 8, SJR: 0.957, h-index: 67)
Animal Science J.     Hybrid Journal   (Followers: 6, SJR: 0.569, h-index: 24)
Annalen der Physik     Hybrid Journal   (Followers: 5, SJR: 1.46, h-index: 40)
Annals of Anthropological Practice     Partially Free   (Followers: 2, SJR: 0.187, h-index: 5)
Annals of Applied Biology     Hybrid Journal   (Followers: 8, SJR: 0.816, h-index: 56)
Annals of Clinical and Translational Neurology     Open Access   (Followers: 1)
Annals of Human Genetics     Hybrid Journal   (Followers: 9, SJR: 1.191, h-index: 67)
Annals of Neurology     Hybrid Journal   (Followers: 44, SJR: 5.584, h-index: 241)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 2, SJR: 0.531, h-index: 38)
Annals of Public and Cooperative Economics     Hybrid Journal   (Followers: 9, SJR: 0.336, h-index: 23)
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5, SJR: 2.389, h-index: 189)
Annual Bulletin of Historical Literature     Hybrid Journal   (Followers: 12)
Annual Review of Information Science and Technology     Hybrid Journal   (Followers: 14)
Anthropology & Education Quarterly     Hybrid Journal   (Followers: 24, SJR: 0.72, h-index: 31)
Anthropology & Humanism     Hybrid Journal   (Followers: 17, SJR: 0.137, h-index: 3)
Anthropology News     Hybrid Journal   (Followers: 15)
Anthropology of Consciousness     Hybrid Journal   (Followers: 11, SJR: 0.172, h-index: 5)
Anthropology of Work Review     Hybrid Journal   (Followers: 11, SJR: 0.256, h-index: 5)
Anthropology Today     Hybrid Journal   (Followers: 94, SJR: 0.545, h-index: 15)
Antipode     Hybrid Journal   (Followers: 45, SJR: 2.212, h-index: 69)
Anz J. of Surgery     Hybrid Journal   (Followers: 6, SJR: 0.432, h-index: 59)
Anzeiger für Schädlingskunde     Hybrid Journal   (Followers: 1)
Apmis     Hybrid Journal   (Followers: 1, SJR: 0.855, h-index: 73)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 69, SJR: 0.754, h-index: 69)
Applied Organometallic Chemistry     Hybrid Journal   (Followers: 7, SJR: 0.632, h-index: 58)
Applied Psychology     Hybrid Journal   (Followers: 139, SJR: 1.023, h-index: 64)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 48, SJR: 0.868, h-index: 13)
Applied Stochastic Models in Business and Industry     Hybrid Journal   (Followers: 5, SJR: 0.613, h-index: 24)
Aquaculture Nutrition     Hybrid Journal   (Followers: 14, SJR: 1.025, h-index: 55)
Aquaculture Research     Hybrid Journal   (Followers: 31, SJR: 0.807, h-index: 60)
Aquatic Conservation Marine and Freshwater Ecosystems     Hybrid Journal   (Followers: 34, SJR: 1.047, h-index: 57)
Arabian Archaeology and Epigraphy     Hybrid Journal   (Followers: 11, SJR: 0.453, h-index: 11)
Archaeological Prospection     Hybrid Journal   (Followers: 12, SJR: 0.922, h-index: 21)
Archaeology in Oceania     Hybrid Journal   (Followers: 13, SJR: 0.745, h-index: 18)
Archaeometry     Hybrid Journal   (Followers: 27, SJR: 0.809, h-index: 48)
Archeological Papers of The American Anthropological Association     Hybrid Journal   (Followers: 14, SJR: 0.156, h-index: 2)
Architectural Design     Hybrid Journal   (Followers: 25, SJR: 0.261, h-index: 9)
Archiv der Pharmazie     Hybrid Journal   (Followers: 4, SJR: 0.628, h-index: 43)
Archives of Drug Information     Hybrid Journal   (Followers: 4)
Archives of Insect Biochemistry and Physiology     Hybrid Journal   (SJR: 0.768, h-index: 54)
Area     Hybrid Journal   (Followers: 12, SJR: 0.938, h-index: 57)
Art History     Hybrid Journal   (Followers: 224, SJR: 0.153, h-index: 13)
Arthritis & Rheumatology     Hybrid Journal   (Followers: 50, SJR: 1.984, h-index: 20)
Arthritis Care & Research     Hybrid Journal   (Followers: 28, SJR: 2.256, h-index: 114)
Artificial Organs     Hybrid Journal   (Followers: 1, SJR: 0.872, h-index: 60)
ASHE Higher Education Reports     Hybrid Journal   (Followers: 14)
Asia & the Pacific Policy Studies     Open Access   (Followers: 14)
Asia Pacific J. of Human Resources     Hybrid Journal   (Followers: 317, SJR: 0.494, h-index: 19)
Asia Pacific Viewpoint     Hybrid Journal   (SJR: 0.616, h-index: 26)
Asia-Pacific J. of Chemical Engineering     Hybrid Journal   (Followers: 7, SJR: 0.345, h-index: 20)
Asia-pacific J. of Clinical Oncology     Hybrid Journal   (Followers: 6, SJR: 0.554, h-index: 14)
Asia-Pacific J. of Financial Studies     Hybrid Journal   (SJR: 0.241, h-index: 7)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 3, SJR: 0.377, h-index: 7)
Asian Economic J.     Hybrid Journal   (Followers: 8, SJR: 0.234, h-index: 21)
Asian Economic Policy Review     Hybrid Journal   (Followers: 4, SJR: 0.196, h-index: 12)
Asian J. of Control     Hybrid Journal   (SJR: 0.862, h-index: 34)
Asian J. of Endoscopic Surgery     Hybrid Journal   (SJR: 0.394, h-index: 7)
Asian J. of Organic Chemistry     Hybrid Journal   (Followers: 4, SJR: 1.443, h-index: 19)
Asian J. of Social Psychology     Hybrid Journal   (Followers: 5, SJR: 0.665, h-index: 37)
Asian Politics and Policy     Hybrid Journal   (Followers: 12, SJR: 0.207, h-index: 7)
Asian Social Work and Policy Review     Hybrid Journal   (Followers: 5, SJR: 0.318, h-index: 5)
Asian-pacific Economic Literature     Hybrid Journal   (Followers: 5, SJR: 0.168, h-index: 15)
Assessment Update     Hybrid Journal   (Followers: 4)
Astronomische Nachrichten     Hybrid Journal   (Followers: 2, SJR: 0.701, h-index: 40)
Atmospheric Science Letters     Open Access   (Followers: 29, SJR: 1.332, h-index: 27)
Austral Ecology     Hybrid Journal   (Followers: 13, SJR: 1.095, h-index: 66)
Austral Entomology     Hybrid Journal   (Followers: 10, SJR: 0.524, h-index: 28)
Australasian J. of Dermatology     Hybrid Journal   (Followers: 8, SJR: 0.714, h-index: 40)
Australasian J. On Ageing     Hybrid Journal   (Followers: 7, SJR: 0.39, h-index: 22)
Australian & New Zealand J. of Statistics     Hybrid Journal   (Followers: 13, SJR: 0.275, h-index: 28)
Australian Accounting Review     Hybrid Journal   (Followers: 4, SJR: 0.709, h-index: 14)
Australian and New Zealand J. of Family Therapy (ANZJFT)     Hybrid Journal   (Followers: 3, SJR: 0.382, h-index: 12)
Australian and New Zealand J. of Obstetrics and Gynaecology     Hybrid Journal   (Followers: 43, SJR: 0.814, h-index: 49)
Australian and New Zealand J. of Public Health     Hybrid Journal   (Followers: 11, SJR: 0.82, h-index: 62)
Australian Dental J.     Hybrid Journal   (Followers: 7, SJR: 0.482, h-index: 46)
Australian Economic History Review     Hybrid Journal   (Followers: 4, SJR: 0.171, h-index: 12)
Australian Economic Papers     Hybrid Journal   (Followers: 25, SJR: 0.23, h-index: 9)
Australian Economic Review     Hybrid Journal   (Followers: 6, SJR: 0.357, h-index: 21)
Australian Endodontic J.     Hybrid Journal   (Followers: 3, SJR: 0.513, h-index: 24)
Australian J. of Agricultural and Resource Economics     Hybrid Journal   (Followers: 3, SJR: 0.765, h-index: 36)
Australian J. of Grape and Wine Research     Hybrid Journal   (Followers: 5, SJR: 0.879, h-index: 56)
Australian J. of Politics & History     Hybrid Journal   (Followers: 13, SJR: 0.203, h-index: 14)
Australian J. of Psychology     Hybrid Journal   (Followers: 18, SJR: 0.384, h-index: 30)
Australian J. of Public Administration     Hybrid Journal   (Followers: 402, SJR: 0.418, h-index: 29)
Australian J. of Rural Health     Hybrid Journal   (Followers: 4, SJR: 0.43, h-index: 34)
Australian Occupational Therapy J.     Hybrid Journal   (Followers: 68, SJR: 0.59, h-index: 29)
Australian Psychologist     Hybrid Journal   (Followers: 11, SJR: 0.331, h-index: 31)
Australian Veterinary J.     Hybrid Journal   (Followers: 19, SJR: 0.459, h-index: 45)
Autism Research     Hybrid Journal   (Followers: 31, SJR: 2.126, h-index: 39)
Autonomic & Autacoid Pharmacology     Hybrid Journal   (SJR: 0.371, h-index: 29)
Banks in Insurance Report     Hybrid Journal   (Followers: 1)
Basic & Clinical Pharmacology & Toxicology     Hybrid Journal   (Followers: 10, SJR: 0.539, h-index: 70)
Basic and Applied Pathology     Open Access   (Followers: 2, SJR: 0.113, h-index: 4)
Basin Research     Hybrid Journal   (Followers: 5, SJR: 1.54, h-index: 60)
Bauphysik     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 5)
Bauregelliste A, Bauregelliste B Und Liste C     Hybrid Journal  
Bautechnik     Hybrid Journal   (Followers: 1, SJR: 0.321, h-index: 11)
Behavioral Interventions     Hybrid Journal   (Followers: 9, SJR: 0.297, h-index: 23)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 23, SJR: 0.736, h-index: 57)
Berichte Zur Wissenschaftsgeschichte     Hybrid Journal   (Followers: 9, SJR: 0.11, h-index: 5)
Beton- und Stahlbetonbau     Hybrid Journal   (Followers: 2, SJR: 0.493, h-index: 14)
Biochemistry and Molecular Biology Education     Hybrid Journal   (Followers: 6, SJR: 0.311, h-index: 26)
Bioelectromagnetics     Hybrid Journal   (Followers: 1, SJR: 0.568, h-index: 64)
Bioengineering & Translational Medicine     Open Access  
BioEssays     Hybrid Journal   (Followers: 10, SJR: 3.104, h-index: 155)
Bioethics     Hybrid Journal   (Followers: 14, SJR: 0.686, h-index: 39)
Biofuels, Bioproducts and Biorefining     Hybrid Journal   (Followers: 1, SJR: 1.725, h-index: 56)
Biological J. of the Linnean Society     Hybrid Journal   (Followers: 15, SJR: 1.172, h-index: 90)
Biological Reviews     Hybrid Journal   (Followers: 3, SJR: 6.469, h-index: 114)
Biologie in Unserer Zeit (Biuz)     Hybrid Journal   (Followers: 42, SJR: 0.12, h-index: 1)
Biology of the Cell     Full-text available via subscription   (Followers: 9, SJR: 1.812, h-index: 69)
Biomedical Chromatography     Hybrid Journal   (Followers: 6, SJR: 0.572, h-index: 49)
Biometrical J.     Hybrid Journal   (Followers: 5, SJR: 0.784, h-index: 44)
Biometrics     Hybrid Journal   (Followers: 37, SJR: 1.906, h-index: 96)
Biopharmaceutics and Drug Disposition     Hybrid Journal   (Followers: 10, SJR: 0.715, h-index: 44)
Biopolymers     Hybrid Journal   (Followers: 18, SJR: 1.199, h-index: 104)
Biotechnology and Applied Biochemistry     Hybrid Journal   (Followers: 45, SJR: 0.415, h-index: 55)
Biotechnology and Bioengineering     Hybrid Journal   (Followers: 136, SJR: 1.633, h-index: 146)
Biotechnology J.     Hybrid Journal   (Followers: 13, SJR: 1.185, h-index: 51)
Biotechnology Progress     Hybrid Journal   (Followers: 39, SJR: 0.736, h-index: 101)
Biotropica     Hybrid Journal   (Followers: 18, SJR: 1.374, h-index: 71)
Bipolar Disorders     Hybrid Journal   (Followers: 9, SJR: 2.592, h-index: 100)
Birth     Hybrid Journal   (Followers: 35, SJR: 0.763, h-index: 64)
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 2, SJR: 0.727, h-index: 77)
Birth Defects Research Part B: Developmental and Reproductive Toxicology     Hybrid Journal   (Followers: 5, SJR: 0.468, h-index: 47)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal   (SJR: 1.513, h-index: 55)
BJOG : An Intl. J. of Obstetrics and Gynaecology     Partially Free   (Followers: 224, SJR: 2.083, h-index: 125)

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Journal Cover American Journal on Addictions
  [SJR: 0.843]   [H-I: 57]   [9 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1055-0496 - ISSN (Online) 1521-0391
   Published by John Wiley and Sons Homepage  [1577 journals]
  • Learning from Latino voices: Focus Groups’ Insights on Participation
           in Genetic Research
    • Authors: Priscilla Martinez; Cory Cummings, Katherine J. Karriker-Jaffe, Karen G. Chartier
      Abstract: Background and ObjectivesThere is a paucity of genetics research examining alcohol use among Latinos. The purpose of this study is to examine Latino perceptions of participation in alcohol studies that collect biological samples, an important precursor to increasing their participation in genetics research.MethodsA synthesis of the literature addressing participation of racial/ethnic minorities in alcohol genetics research was undertaken. We developed a framework of themes related to barriers and facilitators for participation, which we then used to analyze two focus groups held with 18 Latino participants.ResultsFrom the literature review, we identified nine themes related to facilitators of and barriers to participation. They are, on continua: curiosity to disinterest; trust to mistrust; understanding to confusion; safety to danger; inclusion to exclusion; sense of connection to disconnection; hope to despair; ease to hassle; and benefit to cost. Another theme emerged from the focus groups: previous experience to no previous experience with health research.ConclusionsApplying the themes from the literature review to Latino perspectives on providing biological samples for alcohol research helps expand their definition and applicability. Consideration of these themes when designing recruitment/retention materials and strategies may encourage Latino participation in alcohol genetics research.Scientific SignificanceAn understanding of these themes and their significance for Latinos is offered in the form of “guiding questions” for researchers to consider as we strive for more inclusive research. Focus group participants were Mexican American; future research should further explore perspectives of this heterogeneous demographic group by studying other Latino subgroups. (Am J Addict 2017;XX:1–9)
      PubDate: 2017-04-04T11:30:30.053937-05:
      DOI: 10.1111/ajad.12531
       
  • Hospitalized opioid-dependent patients: Exploring predictors of
           buprenorphine treatment entry and retention after discharge
    • Authors: Christina S. Lee; Jane M. Liebschutz, Bradley J. Anderson, Michael D. Stein
      Abstract: ObjectivesFew studies have explored predictors of entry into and retention in buprenorphine treatment following linkage from an acute medical hospitalization.MethodsThis secondary analysis of a completed clinical trial focuses on medically hospitalized, opioid-dependent patients (n = 72) who were randomized to an intervention including buprenorphine induction and dose stabilization during hospitalization followed by post-discharge transition to office-based buprenorphine treatment (OBOT). Predictors included demographics, days hospitalized, prior buprenorphine/methadone treatment, PTSD symptoms, social support, and readiness for drug use cessation. Outcome variables were treatment entry and retention (number of days in OBOT).ResultsPrevious buprenorphine treatment, more days hospitalized, and higher PTSD symptoms predicted OBOT entry. Prior treatment, older age, and non-minority status were associated with a higher mean number of days in OBOT.ConclusionsOBOT may appeal to patients who have tried buprenorphine in other settings. Linking hospitalized patients to OBOT may improve utilization of addiction treatment.Scientific SignificancePrior substance treatment, longer hospital stay, and mental health should be examined in future linkage studies. (Am J Addict 2017;XX:1–6)
      PubDate: 2017-03-21T12:06:40.181606-05:
      DOI: 10.1111/ajad.12533
       
  • (Invited review) genetic research on alcohol use outcomes in African
           American populations: A review of the literature, associated challenges,
           and implications
    • Authors: Danielle M. Dick; Peter Barr, Mignonne Guy, Aashir Nasim, Denise Scott
      Abstract: Background and ObjectivesThere have been remarkable advances in understanding genetic influences on complex traits; however, individuals of African descent have been underrepresented in genetic research.MethodsWe review the limitations of existing genetic research on alcohol phenotypes in African Americans (AA) including both twin and gene identification studies, possible reasons for underrepresentation of AAs in genetic research, the implications of the lack of racially diverse samples, and special considerations regarding conducting genetic research in AA populations.ResultsThere is a marked absence of large-scale AA twin studies so little is known about the genetic epidemiology of alcohol use and problems among AAs. Individuals of African descent have also been underrepresented in gene identification efforts; however, there have been recent efforts to enhance representation. It remains unknown the extent to which genetic variants associated with alcohol use outcomes in individuals of European and African descent will be shared. Efforts to increase representation must be accompanied by careful attention to the ethical, legal, and social implications of genetic research. This is particularly true for AAs due to the history of abuse by the biomedical community and the persistent racial discrimination targeting this population.Conclusions and Scientific SignificanceLack of representation in genetic studies limits our understanding of the etiological factors that contribute to substance use and psychiatric outcomes in populations of African descent and has the potential to further perpetuate health disparities. Involving individuals of diverse ancestry in discussions about genetic research will be critical to ensure that all populations benefit equally from genetic advances. (Am J Addict 2017;XX:1–8)
      PubDate: 2017-02-27T11:20:24.759753-05:
      DOI: 10.1111/ajad.12495
       
  • Environmental influences on alcohol use: Informing research on the joint
           effects of genes and the environment in diverse U.S. populations
    • Authors: Karen G. Chartier; Katherine J. Karriker-Jaffe, Cory R. Cummings, Kenneth S. Kendler
      Abstract: Background and ObjectivesThis review aimed to inform the current state of alcohol research on the joint effects of genes and the environment conducted in U.S. racial/ethnic minority populations, focusing on African Americans, Latinos/Hispanics, Asians, and American Indians.MethodsA key-word and author-based search was conducted and supplemented with direct contact to researchers in this area to ensure a comprehensive inclusion of published, peer-reviewed studies. These studies were considered in terms of the racial/ethnic population groups, phenotypes, genetic variants, and environmental influences covered. Research findings from alcohol epidemiologic studies were highlighted to introduce some potential environmental variables for future studies of gene and environment (G–E) relationships.ResultsTwenty-six (N = 26) studies were reviewed. They predominantly involved African American and Asian samples and had a very limited focus on Latinos/Hispanics and American Indians. There was a wide range of alcohol-related phenotypes examined, and studies almost exclusively used a candidate gene approach. Environmental influences focused on the most proximate social network relationships with family and peers. There was far less examination of community- and societal-level environmental influences on drinking. Epidemiologic studies informing the selection of potential environmental factors at these higher order levels suggest inclusion of indicators of drinking norms, alcohol availability, socioeconomic disadvantage, and unfair treatment.ConclusionsThe review of current literature identified a critical gap in the study of environments: There is the need to study exposures at community and societal levels.Scientific SignificanceThese initial studies provide an important foundation for evolving the dialogue and generating other investigations of G–E relationships in diverse racial/ethnic groups. (Am J Addict 2017;XX:1–15)
      PubDate: 2017-01-24T11:55:26.080404-05:
      DOI: 10.1111/ajad.12478
       
  • Use of Asian samples in genetic research of alcohol use disorders: Genetic
           
    • Authors: Sachio Matsushita; Susumu Higuchi
      Abstract: Background and ObjectivesEpidemiological studies consistently find that Asian populations report lower rates of alcohol use disorders (AUD) compared with other racial groups. These differences result from a variety of biological, genetic, and environmental influences, some of which are related to the metabolism of alcohol. We will review several studies of these metabolic factors, including several alcohol clamping studies conducted in our laboratory, that provide further insight into the role of the alcohol metabolizing genes and drinking behavior among Japanese drinkers.MethodsThis manuscript reviewed studies investigating genetic variations of alcohol metabolizing enzymes among Asians and several mechanisms by which these genes are thought to give rise to differences in rates of alcohol dependence.ResultsThe inactive aldehyde dehydrogenase 2 (ALDH2) and highly active alcohol dehydrogenase-1B (ADH1B) genes are protective factors for the development of AUD. The inactive ALDH2 provides its protective effect through the accumulation of acetaldehyde after consuming alcohol, resulting in unpleasant effects, and heightened sensitivity to alcohol. However, the suppressive effects of inactive ALDH2 and highly active ADH1B for AUDs are only partial and interact with other factors, such as personality traits, psychiatric comorbidities, and environmental factors.Discussion and ConclusionsWhile Asians are excellent models for the study of certain genetic effects on the development and consequences of AUD, few clinical studies of this population have been conducted. Further exploration of the interactions between various genetic, individual, and environmental factors influencing drinking behavior and, thus affecting the risk of AUD, would enhance our understanding of how alcohol-related problems develop.Scientific SignificanceThe heterozygous ALDH2*1/*2 genotype has only partial effects on limiting drinking behavior, suggesting the potential interaction with other factors. Therefore AUD patients with inactive ALDH2 may be a useful model to identify and to test a variety of other risk factors of AUD. (Am J Addict 2017;XX:1–8)
      PubDate: 2017-01-18T06:05:39.520792-05:
      DOI: 10.1111/ajad.12477
       
  • Compulsive buying
    • Authors: Astrid Müller; James E. Mitchell, Martina de Zwaan
      Abstract: ObjectiveAlthough compulsive buying (CB) seems to be not only prevalent but even increasing in prevalence, it often remains neglected or minimized in clinical settings. There is a need for a greater understanding and recognition of this problem. The aim of this article is to summarize the current knowledge regarding CB and to offer thoughts regarding classification.MethodReview of published literature over the period 1994–2013 through Pubmed/Medline, PsychINFO, and Google Scholar using the key words ‘compulsive buying’, ‘impulsive buying’ and ‘addictive buying’.ResultsCB is defined by a preoccupation with buying and shopping, by frequent buying episodes, or overpowering urges to buy that are experienced as irresistible and senseless. The maladaptive spending behavior is associated with serious psychological, social, occupational, and financial problems. Treatment-seeking patients with CB suffer from substantial psychiatric comorbidity (eg, anxiety and depressive mood disorders, compulsive hoarding, binge eating disorder). Representative surveys revealed prevalence estimates of CB between 6% and 7% and indicate that younger people are more prone to develop CB. Moreover, European data suggest an increase of CB in the adult population over the last 20 years. While there is no evidence for the efficacy of psychopharmacological treatment, group cognitive behavioral therapy has been shown to be effective.ConclusionThe relevance of recognition of CB as mental disorder is undeniable in the face of its estimated prevalence and associated burden. As our understanding of contributing neurobiological and etiological factors is limited, further research should focus on these topics, taking into account the heterogeneity of individuals with CB. There is also a need for specific treatment options and for the development of prevention strategies. (Am J Addict 2013;XX:1–6)
      PubDate: 2013-10-04T12:05:40.350085-05:
      DOI: 10.1111/j.1521-0391.2013.12111.x
       
  • Epidemiological trends and the advances of treatments of amphetamine-type
           stimulants (ATS) in China
    • Authors: Hong-Qiang Sun; Hong-Mei Chen, Fu-De Yang, Lin Lu, Thomas R. Kosten
      Abstract: Background and ObjectivesAmphetamine-type stimulants (ATS) have quickly spread and been widely abused in many parts of the world, particularly in China. This review focuses on and describes the epidemiological trends and the advances of treatments of ATS in China.MethodsA descriptive study based on literature identified from searches of the China National Knowledge Infrastructure (1979–2013), PubMed databases, hand-picked references, and online references with emphasis on epidemiology, treatment and traditional Chinese medicine. This review covers some traditional Chinese treatments and their complementary Western approaches.Results and ConclusionsThe epidemiological trends of ATS in China have led to its being 2.2 times the rate of morphine abuse and second only to marijuana abuse. The treatment programs in China have used traditional herbal approaches as well as acupuncture, often in combination with Western medications such as fluoxetine for depression associated with ATS abuse. Other herbal treatments have reversed the cardiac arrhythmias associated with ATS intoxication, and acupuncture has been used successfully for the protracted depressive and somatic symptoms of ATS withdrawal over a period of 3 months.Scientific SignificanceThese traditional Chinese treatments may be increasingly available to the world, but will remain a consistent complementary therapy for ATS in China and the Far East, where ATS has become such a prevalent problem. (Am J Addict 2013;XX:000–000)
      PubDate: 2013-09-20T10:15:29.41978-05:0
      DOI: 10.1111/j.1521-0391.2013.12116.x
       
  • Gambling disorder and its relationship with substance use disorders:
           Implications for nosological revisions and treatment
    • Authors: Jon E. Grant; Samuel R. Chamberlain
      Abstract: BackgroundGambling disorder, recognized by the DSM-5 as a behavioral addiction, affects .4–1.6% of adults worldwide, and is highly comorbid with other mental health disorders, particularly substance use disorders (SUDs).ObjectivesTo provide a concise primer on the relationship between gambling disorder and SUDs, focusing on phenomenology/clinical presentation, co-morbidity, familiality, cognition, neuroanatomy/neurochemistry, and treatment.MethodsSelective review of the literature.ResultsScientific evidence shows that gambling and SUDs have consistently high rates of comorbidity, similar clinical presentations, and some genetic and physiological overlap. Several treatment approaches show promise for gambling disorder, some of which have previously been effective for SUDs.Scientific SignificanceIt is hoped that recognition of overlap between gambling disorder and SUDs in terms of phenomenology and neurobiology will signal novel treatment approaches and raise the profile of this neglected condition. (Am J Addict 2013;XX:1–6)
      PubDate: 2013-09-18T22:35:29.381306-05:
      DOI: 10.1111/j.1521-0391.2013.12112.x
       
  • New developments on the neurobiological and pharmaco-genetic mechanisms
           underlying internet and videogame addiction
    • Authors: Aviv Weinstein; Michel Lejoyeux
      Abstract: BackgroundThere is emerging evidence that the psychobiological mechanisms underlying behavioral addictions such as internet and videogame addiction resemble those of addiction for substances of abuse.ObjectivesReview of brain imaging, treatment and genetic studies on videogame and internet addiction.MethodsLiterature search of published articles between 2009 and 2013 in Pubmed using “internet addiction” and “videogame addiction” as the search word. Twenty-nine studies have been selected and evaluated under the criteria of brain imaging, treatment, and genetics.ResultsBrain imaging studies of the resting state have shown that long-term internet game playing affected brain regions responsible for reward, impulse control and sensory-motor coordination. Brain activation studies have shown that videogame playing involved changes in reward and loss of control and that gaming pictures have activated regions similarly to those activated by cue-exposure to drugs. Structural studies have shown alterations in the volume of the ventral striatum possible as result of changes in reward. Furthermore, videogame playing was associated with dopamine release similar in magnitude to those of drugs of abuse and that there were faulty inhibitory control and reward mechanisms videogame addicted individuals. Finally, treatment studies using fMRI have shown reduction in craving for videogames and reduced associated brain activity.Conclusions and Scientific SignificanceVideogame playing may be supported by similar neural mechanisms underlying drug abuse. Similar to drug and alcohol abuse, internet addiction results in sub-sensitivity of dopamine reward mechanisms. Given the fact that this research is in its early stage it is premature to conclude that internet addiction is equivalent to substance addictions. (Am J Addict 2013;XX:1–9)
      PubDate: 2013-09-13T09:26:01.2589-05:00
       
  • Differential diagnosis for a stable patient maintained on buprenorphine
           who gives a urine toxicology screen negative for buprenorphine
    • Authors: Roopa Sethi; Ismene Petrakis
      PubDate: 2013-09-13T09:25:46.707051-05:
      DOI: 10.1111/j.1521-0391.2013.12087.x
       
  • Alcohol and drug use in groups of cannabis users: Results from a survey on
           drug use in the Swedish general population
    • Authors: Jonas Berge; Anders Håkansson, Mats Berglund
      Abstract: Background and ObjectivesAlthough cannabis is well studied in the scientific literature, relatively little is known about the relationship between the frequency of cannabis use and the use of alcohol and other drugs. The aim of this study was to identify differences between frequent and occasional cannabis users with respect to the use of other illicit drugs, hazardous alcohol use, and unauthorized use of prescription drugs.MethodsResults from a questionnaire on drug use taken by 22,095 individuals in the Swedish general population were analyzed with a logistic regression model. Active cannabis use was defined as having used cannabis in the past 12 months. Use of cannabis two-to-three times per week or more was classified as frequent use.ResultsCannabis users were more likely to report hazardous alcohol use, use of other illicit drugs, and unauthorized use of prescription drugs than were non-users. Within the group of active cannabis users, frequent cannabis use, compared to occasional use, was associated with the use of other illicit drugs and negatively associated with hazardous alcohol use.Discussion and ConclusionsThe association between cannabis use and hazardous alcohol use, use of other illicit drugs, and unauthorized use of prescription drugs was expected. However, the negative association between frequent cannabis use and hazardous alcohol use among active cannabis users was surprising. This indicates that frequent cannabis users may differ from more occasional users in clinical needs.Scientific SignificanceThese results show a previously unknown characteristic of the association between frequency of cannabis use and hazardous alcohol use in the general population. (Am J Addict 2013;XX:1–8)
      PubDate: 2013-09-12T23:35:34.386086-05:
      DOI: 10.1111/j.1521-0391.2013.12097.x
       
  • Nationwide dissemination of contingency management: The veterans
           administration initiative
    • Authors: Nancy M. Petry; Dominick DePhilippis, Carla J. Rash, Michelle Drapkin, James R. McKay
      Abstract: BackgroundContingency management (CM) is an empirically validated intervention but one not often applied in practice settings in the US.ObjectivesThe aim of this article is to describe the veterans administration (VA) nationwide implementation of CM treatment.MethodsIn 2011, the VA called for integration of CM in its intensive outpatient substance abuse treatment clinics. As part of this initiative, the VA funded trainings and ongoing implementation support, and it provided direct funds for reinforcers and other intervention costs.ResultsOver 100 clinics received this funding in 2011, and CM has been implemented in over 70 substance abuse treatment clinics since August 2011.ConclusionsThis training and implementation experience has been highly successful and represents the largest scale training in evidence-based treatments for substance use disorders in the VA health care system to date.Scientific SignificanceThis program may serve as a model for training in evidence-based treatments. (Am J Addict 2013;XX:1–6)
      PubDate: 2013-09-12T23:34:28.262182-05:
      DOI: 10.1111/j.1521-0391.2013.12092.x
       
  • High levels of opioid analgesic co-prescription among methadone
           maintenance treatment clients in British Columbia, Canada: Results from a
           population-level retrospective cohort study
    • Authors: Bohdan Nosyk; Benedikt Fischer, Huiying Sun, David C. Marsh, Thomas Kerr, Juergen T. Rehm, Aslam H. Anis
      Abstract: Background and ObjectivesThe non-medical use of prescription opioids (PO) has increased dramatically in North America. Special consideration for PO prescription is required for individuals in methadone maintenance treatment (MMT). Our objective is to describe the prevalence and correlates of PO use among British Columbia (BC) MMT clients from 1996 to 2007.MethodsThis study was based on a linked, population-level medication dispensation database. All individuals receiving 30 days of continuous MMT for opioid dependence were included in the study. Key measurements included the proportion of clients receiving >7 days of a PO other than methadone during MMT from 1996 to 2007. Factors independently associated with PO co-prescription during MMT were assessed using generalized linear mixed effects regression.Results16,248 individuals with 27,919 MMT episodes at least 30 days in duration were identified for the study period. Among them, 5,552 individuals (34.2%) received a total of 290,543 PO co-prescriptions during MMT. The majority (74.3%) of all PO dispensations >7 days originated from non-MMT physicians. The number of PO prescriptions per person-year nearly doubled between 1996 and 2006, driven by increases in morphine, hydromorphone and oxycodone dispensations. PO co-prescription was positively associated with female gender, older age, higher levels of medical co-morbidity as well as higher MMT dosage, adherence, and retention.Conclusion and Scientific SignificanceA large proportion of MMT clients in BC received co-occurring PO prescriptions, often from physicians and pharmacies not delivering MMT. Experimental evidence for the treatment of pain in MMT clients is required to guide clinical practice. (Am J Addict 2013;XX:1–8)
      PubDate: 2013-09-12T23:34:05.039411-05:
      DOI: 10.1111/j.1521-0391.2013.12091.x
       
  • Implementing substance abuse group therapy clinical trials in real-world
           settings: Challenges and strategies for participant recruitment and
           therapist training in the Women's Recovery Group Study
    • Authors: Shelly F. Greenfield; Michele A. Crisafulli, Julia S. Kaufman, Cathryn M. Freid, Genie L. Bailey, Hilary S. Connery, Michelle Rapoza, John Rodolico
      Abstract: Background and ObjectivesOpen-enrollment group therapy research is challenged by the participant recruitment necessary to ensure continuous group enrollment. We present successful strategies to overcome the following barriers during the Women's Recovery Group (WRG) two-site clinical trial (N = 158): maintenance of sample size and balanced gender randomization during continuous enrollment, maintenance of group attendance, and training and retention of therapists over the 24-month continuous group enrollment.MethodsTo increase recruitment, we targeted referral sources yielding the highest enrollment conversion at each site. Group sessions were consistently held regardless of group size. Therapists were trained in two teams allowing for coverage and uninterrupted treatment over 24 months.ResultsAt both sites recruitment and enrollment increased with each successive quarter. Sample size and end date targets were met without disruptions in treatment. Group therapists reported high satisfaction with their training and treatment experiences.Discussion and ConclusionsThese strategies supported targeted enrollment and study duration, stability of open-enrollment group therapy frame, and therapist retention and satisfaction.Scientific SignificanceApplying these strategies can aid in providing evidence-based group therapy in both clinical and research settings. (Am J Addict 2013;XX:000–000)
      PubDate: 2013-09-12T23:30:42.059617-05:
      DOI: 10.1111/j.1521-0391.2013.12099.x
       
  • Pharmacogenetics of naltrexone and disulfiram in alcohol dependent, dually
           diagnosed veterans
    • Authors: Albert J. Arias; Joel Gelernter, Ralitza Gueorguieva, Elizabeth Ralevski, Ismene L. Petrakis
      Abstract: BackgroundDisulfiram and naltrexone were evaluated in treatment of individuals with co-occurring alcohol dependence and other Axis I disorders (e.g., Major Depression). We explored pharmacogenetic interactions in genotyped subjects.MethodsAlcohol dependent (AD) subjects received naltrexone alone, placebo alone, disulfiram with placebo or disulfiram with naltrexone. They were genotyped for OPRM1 rs1799971 (Asn40Asp), and DBH rs1611115 (C-1021T). N = 107 male European-American subjects were included.ResultsThere were no significant interactions with OPRM1. DBH interacted with naltrexone on the primary outcome of abstinence from heavy drinking (χ2(1) = 5.23, p = .02). “T” allele carriers on naltrexone had more abstinence compared to “CC” subjects on naltrexone (FET, p = .01). “T” allele carriers on naltrexone had the highest overall rates of abstinence from heavy drinking (>90%). Also, DBH genotype interacted with disulfram (F(1,17) = 7.52, p = .01) on drinks per drinking day with less drinking for subjects with the “CC” genotype than for T allele carriers on disulfiram.ConclusionsDBH*rs1611115*T associated with better response to naltrexone, while for those on disulfiram that drank, “CC” subjects drank less than T carriers. For rs1799971*G, we did not replicate findings from previous studies showing a more favorable response to NTX, possibly due to the small available sample.Scientific SignificanceGenotyping rs1611115 may be useful in understanding inter-individual differences in AD treatment response.Future DirectionsFurther study of rs1611115 pharmacogenetics is warranted. (Am J Addict 2013;XX:000–000)
      PubDate: 2013-09-12T23:30:29.950855-05:
      DOI: 10.1111/j.1521-0391.2013.12102.x
       
  • Relationships of behavioral measures of frontal lobe dysfunction with
           underlying electrophysiology in cocaine-dependent patients
    • Authors: Klevest Gjini; Aisha Qazi, Mark K. Greenwald, Ravinder Sandhu, Diane C. Gooding, Nash N. Boutros
      Abstract: Background and ObjectivesDespite evidence that frontal lobe functioning is impaired in cocaine-dependent individuals, relationships between behavioral measures of frontal dysfunction and electrophysiological measures of inhibition in cocaine use have not been explored.MethodsUsing the Frontal Systems Behavior Scale (FrSBe), frontal dysfunction was assessed in a group of abstinent cocaine-dependent subjects (N = 49) and healthy controls (N = 32). Using transcranial magnetic stimulation (TMS) and evoked potential (EP)-based electrophysiological measures of inhibition, we assessed associations between these measures and FrSBe estimates of frontal dysfunction.ResultsPatients had significantly higher FrSBe scores for executive dysfunction, disinhibition, and apathy than controls. Lower TMS-based resting motor thresholds (ie, hyperexcitability) were significantly associated with higher executive dysfunction scores in the patients.Conclusions and Scientific SignificanceRelationships between FrSBe scores and TMS-based measures highlight neurophysiological aberrations underlying frontal lobe dysfunction in cocaine abusers. TMS and EP measures may be useful probes of the intermediary steps between frontal lobe dysfunction and addictive behavior. (Am J Addict 2013;XX:1–7)
      PubDate: 2013-08-31T05:41:08.574653-05:
      DOI: 10.1111/j.1521-0391.2013.12095.x
       
  • Does stimulant use impair housing outcomes in low-demand supportive
           housing for chronically homeless adults'
    • Authors: Ellen L. Edens; Jack Tsai, Robert A. Rosenheck
      Abstract: BackgroundRecent research suggests low-demand housing (ie, not contingent upon abstinence) is effective in helping people exit homelessness, even among recent active substance users. Whether active users of illicit drugs and stimulants have worse housing outcomes than primary alcohol users, however, is unknown.MethodsA total of 149 participants in a multisite supportive housing program who reported high levels of active substance use at program entry were classified as either (1) predominantly “Alcohol Use” (>10 of 30 days alcohol, but not >10 days of drug use) or (2) “Illicit Drug Use” (>10 of 30 days any single illicit drug use with or without alcohol use). Sub-analysis of the “Illicit Drug Use” group compared participants reporting high levels of “Stimulant Use” (>10 days cocaine, crack, or methamphetamine use) to those with high levels of “Non-stimulant Use” (>10 days marijuana or other non-stimulant drug use). Group differences in housing outcomes were examined with mixed model multivariate regression.ResultsDuring 24-month follow-up, days housed increased dramatically for both the “Alcohol Use” and the “Illicit Drug Use” groups without significant differences. Sub-analysis of illicit drug users showed stimulant use was associated with fewer days housed (p = .01) and more days homeless (p = .02) over time.ConclusionsAmong illicit drug users, stimulant users have somewhat less successful housing outcomes than other active drug and alcohol users, though both groups maintained substantial housing improvements in low-demand housing. (Am J Addict 2013;XX:000–000)
      PubDate: 2013-08-31T05:41:06.62979-05:0
      DOI: 10.1111/j.1521-0391.2013.12089.x
       
  • Sex differences in smoking cue reactivity: Craving, negative affect, and
           preference for immediate smoking
    • Authors: Neal Doran
      Abstract: Background and ObjectivesFemale smokers have greater difficulty quitting, possibly due to increased reactivity to smoking-related cues. This study assessed sex differences in craving, affect, and preference for immediate smoking after cue exposure.MethodsRegular smokers (n = 60; 50% female) were exposed to smoking and neutral cues in separate, counterbalanced sessions. Outcomes included changes in craving and affect and preference for immediate smoking following cue exposure.ResultsFindings indicated that women exhibited greater preference for immediate smoking (p = .004), and reported greater cue-induced increases in cigarette craving (p = .046) and negative affect (p = .025).Discussion and ConclusionsThese data suggest that women may have greater difficulty inhibiting smoking after cue exposure, possibly as a consequence of greater increases in craving and negative affect.Scientific Significance and Future DirectionsFindings suggest a mechanism that may contribute to greater cessation failure among female smokers. (Am J Addict 2013;XX:1–7)
      PubDate: 2013-08-31T04:17:17.655062-05:
      DOI: 10.1111/j.1521-0391.2013.12094.x
       
  • Attachment security and problematic substance use in low-income, suicidal,
           African American women
    • Authors: Suena H. Massey; Michael T. Compton, Nadine J. Kaslow
      Abstract: Background and ObjectivesWhile secure attachment may buffer the effect of adverse early experiences on the development of behavioral problems in children, whether attachment security may provide resilience against problematic substance use in adulthood is less clear, and addressed by this study.MethodsWe examined relations between attachment security and problematic substance use in 356 African American women recruited for a suicide prevention/intervention study. Problematic substance use was defined as a positive screen on either the Brief Michigan Alcoholism Screening Test or the Drug Abuse Screening Test-10. Attachment security was assessed using the Secure Subscale of the Relationship Scales Questionnaire. Associations between demographic and psychosocial variables (age, education, unemployment, homelessness, attachment security, past childhood maltreatment, current exposure to intimate partner violence, and depressive symptoms) and problematic substance use were determined using logistic regression analyses.ResultsParticipants averaged 35.1 ± 10.0 years of age, and exhibited significant psychosocial challenges. More secure attachment was independently associated with a lower likelihood of problematic drug use (OR = .516, 95% CI (.343–.777), p ≤ .01); and the problematic use of either alcohol or drugs (OR = .563, 95% CI (.374–.849), p ≤ .01). Attachment security, along with childhood maltreatment, age, and homelessness, accounted for 25.5% of the variance in problematic substance use.Discussion and ConclusionsParticipants who reported greater attachment security were significantly less likely to engage in problematic substance use.Scientific SignificanceFuture research should explore attachment security as a resilience factor against problematic substance use. (Am J Addict 2013;XX:1–6)
      PubDate: 2013-08-31T04:07:06.921247-05:
      DOI: 10.1111/j.1521-0391.2013.12104.x
       
  • Cannabis withdrawal in chronic, frequent cannabis smokers during sustained
           abstinence within a closed residential environment
    • Authors: Dayong Lee; Jennifer R. Schroeder, Erin L. Karschner, Robert S. Goodwin, Jussi Hirvonen, David A. Gorelick, Marilyn A. Huestis
      Abstract: ObjectivesChronic, frequent cannabis smokers may experience residual and offset effects, withdrawal, and craving when abstaining from the drug. We characterized the prevalence, duration, and intensity of these effects in chronic frequent cannabis smokers during abstinence on a closed research unit.MethodsNon-treatment-seeking participants (N = 29 on admission, 66% and 34% remaining after 2 and 4 weeks) provided subjective effects data. A battery of five instruments was computer-administered daily to measure psychological, sensory, and physical symptoms associated with cannabinoid intoxication and withdrawal. Plasma and oral fluid specimens were concurrently collected and analyzed for cannabinoids. Outcome variables were evaluated as change from admission (Day 0) with regression models.ResultsMost abstinence effects, including irritability and anxiety were greatest on Days 0–3 and decreased thereafter. Cannabis craving significantly decreased over time, whereas decreased appetite began to normalize on Day 4. Strange dreams and difficulty getting to sleep increased over time, suggesting intrinsic sleep problems in chronic cannabis smokers. Symptoms likely induced by residual drug effects were at maximum intensity on admission and positively correlated with plasma and oral fluid cannabinoid concentrations on admission but not afterward; these symptoms showed overall prevalence higher than cannabis withdrawal symptoms.ConclusionsThe combined influence of residual/offset drug effects, withdrawal, and craving was observed in chronic cannabis smokers during monitored abstinence. Abstinence symptoms were generally more intense in the initial phase, implying importance of early intervention in cannabis quit attempts. Sleep disturbance persisting for an extended period suggests that hypnotic medications could be beneficial in treating cannabis dependence. (Am J Addict 2013;XX:1–9)
      PubDate: 2013-08-31T04:05:31.127845-05:
      DOI: 10.1111/j.1521-0391.2013.12088.x
       
  • Predictors of drinking and functional outcomes for men and women following
           inpatient alcohol treatment
    • Authors: Dawn E. Sugarman; Julia S. Kaufman, Elisa M. Trucco, Jodi C. Brown, Shelly F. Greenfield
      Abstract: Background and ObjectivesThis prospective study uses path analytic models to examine baseline characteristics associated with both functioning and drinking outcomes 12 months after inpatient alcohol treatment.MethodsAlcohol-dependent participants (N = 101) were recruited during inpatient alcohol treatment and assessed monthly 1 year after discharge.ResultsAlcohol severity was negatively associated with education and self-efficacy; marital status was positively associated with self-efficacy; and education and self-efficacy were negatively associated with drinking outcomes. Low alcohol severity, not having a depression diagnosis, and being married were associated with less social support impairment, which was in turn associated with better drinking outcomes. Having a history of sexual abuse did not influence drinking outcomes. However, having a history of sexual abuse was negatively associated with global functioning.Conclusions and Scientific SignificanceDrinking outcomes were associated with education, self-efficacy, social support, and diagnosis of depression at baseline; however, global functioning 1 year following treatment was primarily and negatively associated with sexual abuse history. Future treatment research should include measures of both functioning and drinking behavior outcomes. (Am J Addict 2013;XX:1–9)
      PubDate: 2013-08-31T04:05:24.028217-05:
      DOI: 10.1111/j.1521-0391.2013.12098.x
       
  • Prevalence of psychiatric disorders among heroin users who received
           methadone maintenance therapy in Taiwan
    • Authors: Chiung-Yueh Fan; Happy Kuy-Lok Tan, I-Chia Chien, Sun-Yuan Chou
      Abstract: BackgroundMany patients under methadone maintenance treatment are present with comorbid psychiatric symptoms.ObjectiveWe wish to examine the prevalence of psychiatric disorders among heroin users who received methadone maintenance therapy (MMT) in Taiwan.MethodsBy combining the National Health Insurance Research database and Center for Disease Control database, 18,271 heroin users who received MMT were defined as the subject group and after matching age and sex, 73,084 patients were randomly selected as the control group.ResultsThe 1 year prevalence of any psychiatric disorder, any psychotic disorder, neurotic and other nonpsychotic disorder among MMT patients and control group were 13.14% versus 2.50% (OR 5.89, CI 5.53–6.27), 4.21% versus 1.29% (OR 3.38, CI 3.07–3.72), and 9.89% versus 1.31% (OR 8.25, CI 7.62–8.94), respectively.ConclusionThe prevalence of any co-morbid psychiatric disorder among MMT patients is almost six times higher than the control group.Scientific SignificanceA thorough psychiatric screening and appropriate aggressive intervention should be incorporated into an effective methadone treatment program. (Am J Addict 2013;XX:1–8)
      PubDate: 2013-08-19T00:39:16.829601-05:
      DOI: 10.1111/j.1521-0391.2013.12090.x
       
  • Alcoholics anonymous and twelve-step recovery: A model based on social and
           cognitive neuroscience
    • Authors: Marc Galanter
      Abstract: BackgroundIn the course of achieving abstinence from alcohol, longstanding members of Alcoholics Anonymous (AA) typically experience a change in their addiction-related attitudes and behaviors. These changes are reflective of physiologically grounded mechanisms which can be investigated within the disciplines of social and cognitive neuroscience.ObjectiveThis article is designed to examine recent findings associated with these disciplines that may shed light on the mechanisms underlying this change.MethodLiterature review and hypothesis development.ResultsPertinent aspects of the neural impact of drugs of abuse are summarized. After this, research regarding specific brain sites, elucidated primarily by imaging techniques, is reviewed relative to the following: Mirroring and mentalizing are described in relation to experimentally modeled studies on empathy and mutuality, which may parallel the experiences of social interaction and influence on AA members. Integration and retrieval of memories acquired in a setting like AA are described, and are related to studies on storytelling, models of self-schema development, and value formation. A model for ascription to a Higher Power is presented.ConclusionThe phenomena associated with AA reflect greater complexity than the empirical studies on which this article is based, and certainly require further elucidation. Despite this substantial limitation in currently available findings, there is heuristic value in considering the relationship between the brain-based and clinical phenomena described here.Scientific SignificanceThere are opportunities for the study of neuroscientific correlates of Twelve-Step-based recovery, and these can potentially enhance our understanding of related clinical phenomena. (Am J Addict 2013;XX:1–8)
      PubDate: 2013-08-12T06:34:19.070625-05:
      DOI: 10.1111/j.1521-0391.2013.12106.x
       
  • Ameliorative response to detoxification, psychotherapy, and medical
           management in patients maintained on opioids for pain
    • Abstract: Background and ObjectivesThe prevalence of opioid-induced hyperalgesia (OIH) among patients maintained on opioids for chronic non-malignant pain has not been estimated. As a contribution toward establishing its prevalence, we report a case series of opioid maintained patients whose pain tolerance was measured by the cold pressor test at baseline.MethodsA case series of 117 patients who had undergone detoxification was reviewed retrospectively. Most patients (n = 108) and selected non-addicted support persons who accompanied them (controls; n = 37) had cold pressor time (CPT) assessments at baseline. Twenty patients had a repeat CPT after 1 month.ResultsWhen 61 patients completed one month abstinent reported pain was improved (51%), unchanged (46%), or worse (3%). Baseline CPT was 48 sec for patients and 102 sec for controls, suggesting that opioid maintained patients were more pain sensitive than opioid naïve controls. CPT increased for 90% of 1-month completers, suggesting improved pain tolerance. Ameliorative response to detoxification, psychotherapy, and medical management, as defined as the absence of worsening pain with removal of opioids, was 97% in this population.ConclusionThe difference in CPT between opioid maintained patients and controls, and the response to detoxification, psychotherapy and medical management suggest the possibility that the prevalence of OIH may be high.Scientific SignificanceThis study adds to the growing evidence that chronic opioid treatment contributes little to the management of chronic pain and in fact appears to frequently make it worse. (Am J Addict 2017;XX:1–6)
       
  • Use of non-pharmacological strategies for pain relief in addiction
           treatment patients with chronic pain
    • Abstract: Background and ObjectivesWe examined use of non-pharmacological treatments for pain in addiction treatment patients.MethodsPatients in addiction treatment with chronic pain (N = 501) were classified based on use of non-pharmacological pain treatments. Demographic and clinical correlates were compared.ResultsA total of 49% (N = 243) of patients used a non-pharmacological treatment in the past year versus 72% (N = 361) who used opioids. Non-pharmacological treatment users were more likely to use opioids and other pain medications.ConclusionsNon-pharmacological treatments are less commonly used than opioids by addiction treatment patients.Scientific SignificanceFindings highlight the need to better understand pain treatment decision-making among addiction treatment patients. (Am J Addict 2017;XX:1–4)
       
  • Development and preliminary pilot evaluation of a brief tablet computer
           intervention to motivate tobacco quitline use among smokers in substance
           use treatment
    • Abstract: Background and ObjectivesThe majority of individuals in substance use disorder (SUD) treatment also smoke cigarettes; yet, the availability of smoking cessation services in SUD treatment remains limited. In this study, we developed and piloted a brief intervention for smokers in SUD treatment intended to motivate engagement in tobacco quitline treatment (TIME-TQ).MethodsFirst, we interviewed 19 smokers in SUD treatment to inform the development of TIME-TQ (Phase 1). Second, we delivered a prototype TIME-TQ to 16 smokers in the same SUD treatment program and followed them for 3 months post-discharge (Phase 2).ResultsFeedback from Phase 1 participants was used to refine response choices and video segments included in the prototype TIME-TQ. Phase 2 participants rated TIME-TQ high on relevance, interest, respectfulness, and helpfulness. Additionally, they reported significant increases in readiness to quit and perceived importance of quitting after receiving TIME-TQ. A total of 8 of the 16 accepted a quitline referral, and 8 of 13 reached for follow-up (four referral acceptors, four decliners) reported efforts to quit or reduce smoking during the follow-up period. However, only three received quitline counseling and none achieved a sustained period of abstinence.Conclusions and Scientific SignificanceOur results suggest that TIME-TQ activated these patients to quit smoking, but our referral method (standard fax referral) was unsuccessful in helping participants fully engage in quitline treatment or achieving a period of abstinence.Scientific SignificanceWe are now conducting an RCT to evaluate TIME-TQ with a revised referral procedure intended to increase treatment engagement and, ultimately, abstinence rates. (Am J Addict 2017;XX:1–8)
       
  • Text message reminders for improving patient appointment adherence in an
           office-based buprenorphine program: A feasibility study
    • Abstract: Background and ObjectivesMissed visits are common in office-based buprenorphine treatment (OBOT). The feasibility of text message (TM) appointment reminders among OBOT patients is unknown.MethodsThis 6-month prospective cohort study provided TM reminders to OBOT program patients (N = 93). A feasibility survey was completed following delivery of TM reminders and at 6 months.ResultsRespondents reported that the reminders should be provided to all OBOT patients (100%) and helped them to adhere to their scheduled appointment (97%). At 6 months, there were no reports of intrusion to their privacy or disruption of daily activities due to the TM reminders. Most participants reported that the TM reminders were helpful in adhering to scheduled appointments (95%), that the reminders should be offered to all clinic patients (95%), and favored receiving only TM reminders rather than telephone reminders (95%). Barriers to adhering to scheduled appointment times included transportation difficulties (34%), not being able to take time off from school or work (31%), long clinic wait-times (9%), being hospitalized or sick (8%), feeling sad or depressed (6%), and child care (6%).ConclusionsThis study demonstrated the acceptability and feasibility of TM appointment reminders in OBOT. Older age and longer duration in buprenorphine treatment did not diminish interest in receiving the TM intervention. Although OBOT patients expressed concern regarding the privacy of TM content sent from their providers, privacy issues were uncommon among this cohort.Scientific Significance Findings from this study highlighted patient barriers to adherence to scheduled appointments. These barriers included transportation difficulties (34%), not being able to take time off from school or work (31%), long clinic lines (9%), and other factors that may confound the effect of future TM appointment reminder interventions. Further research is also required to assess 1) the level of system changes required to integrate TM appointment reminder tools with already existing electronic medical records and appointment records software; 2) acceptability among clinicians and administrators; and 3) financial and resource constraints to healthcare systems. (Am J Addict 2017;XX:1–6)
       
  • Gambling involvement among Native Americans, Blacks, and Whites in the
           United States
    • Abstract: Background and ObjectivesThis paper examines risk factors of gambling and problem gambling among racial subgroups in the U.S. population, namely Native Americans and blacks, for whom research data are lacking.MethodsFindings are based on a large representative general population survey (n = 3,474) of gambling in the U.S. with an oversample of Native Americans (n = 549). Multiple domains were assessed including sociodemographic factors; ecological factors (census-defined neighborhood disadvantage, geocoded density of casinos within 30 miles of respondents’ homes, and perceived gambling convenience); impulsivity; and alcohol abuse.ResultsAfter controlling for all variables in the study, neighborhood disadvantage has a significantly greater effect on overall gambling, frequent gambling, and problem gambling for Native Americans than for the rest of the U.S. population. In addition, the relationship between frequent gambling and heavier drinking is much stronger for blacks than for the rest of the U.S. population.Discussion and ConclusionsThere is a lack of research on gambling involvement among minority groups in the U.S. Blacks and Native Americans are at a higher risk for problem gambling as compared with the rest of the population. Furthermore, social factors and alcohol abuse may show a stronger co-occurrence with gambling involvement among minority groups than among whites.Scientific SignificanceThis study is a large representative U.S. sample with sizeable numbers of Native Americans and blacks. Thus, prevalence rates and risk factors can be assessed for these important population subgroups. This will allow for targeted intervention programs for Native Americans and blacks with problem gambling and alcohol abuse. (Am J Addict 2017;XX:1–9)
       
  • Role of olfactory reactions, nociception, and immunoendocrine shifts in
           addictive disorders
    • Abstract: Background and ObjectivesAddictive pathology is associated with nervous, immune, and endocrine shifts. Meanwhile, the nature of intersystemic relationship lying beneath addictive disorders remains unclear. The purpose of the study was to identify neuroimmunoendocrine markers of addictive disorders in male subjects defining the nature of their interaction.MethodsThe study enrolled 69 subjects aged 18–43 years: 59 males and 10 females divided into those with addictive disorders (n = 39) and conditionally healthy subjects (n = 30). EEG testing with olfactory stimulation, olfactometric, and pressure algometric examinations was carried out. Multiplex technique was applied to determine mitogen-induced production of cytokines IL-10, IL-1, IL-1RA, IL-2, IFN-gamma, TNF-alpha. ELISA method was applied to measure serum cortisol and testosterone levels.ResultsOlfactory responses to isopropanol with open eyes in addicted patients manifested as increase in alpha-rhythm and beta1-rhythm, with closed eyes presentation of this odorant was accompanied by increase of theta-rhythm in opioid-addicted patients. Male subjects with addictive disorders showed reduced alpha-rhythm in terms of olfactory stimulation with modified emotional evaluation of the odorant, deficient mitogen-induced production of IFN-gamma, and reduced pain sensitivity. Male subjects with opioid addiction had reduced beta1-rhythm in terms of olfactory stimulation, mitogen-induced production of IFN-gamma, and elevated testosterone level.ConclusionsThe findings obtained verify potential involvement of nociception, olfaction, and cytokine production in addiction pathogenesis evidencing their various roles depending on the range of psychoactive substances (PAS) and pathology progression.Scientific SignificanceThe data obtained may provide background for unification of reward circuit and inhibitory control concepts in regulation of addictive behavior. (Am J Addict 2017;XX:1–9)
       
  • Correlates of methamphetamine use among young Iranians: Findings of a
           population-based survey in 2013
    • Abstract: IntroductionMethamphetamine use remains an important public health concern among young people across various international settings. The present study is aimed at investigating the correlates of methamphetamine use among young Iranians within the general population.Materials and MethodsThis study was carried out in 13 provinces of Iran in 2013. Through multistage sampling, 3,246 young adults (aged 19–29 years) were recruited in the study. Weighted multilevel logistic regression methods were applied to identify the correlates of methamphetamine use.ResultsThe lifetime prevalence of methamphetamine use was 7.1% (95% Confidence Interval (CI): 5.4, 8.8). In the multivariable logistic regression, gender (Adjusted Odds Ratio (AOR): 2.57, 95%CI: 1.37, 4.82), marital status (AOR: 4.91, 95%CI: 2.26, 10.7), education level (AOR: 2.56, 95%CI: 1.3, 5.06), profession (AOR: 2.64, 95%CI: 1.63, 4.29), overall knowledge level of methamphetamine use (AOR: 0.55, 95%CI: 0.39, 0.76), knowing a methamphetamine user among family members or friends (AOR: 2.57, 95%CI: 1.71, 4.42), knowing an ecstasy user among family members or friends (AOR: 3.36, 95%CI: 1.92, 5.9), and extramarital sex (AOR: 6.29, 95%CI: 4.29, 9.22) were significantly associated with methamphetamine use.ConclusionsThe lifetime prevalence of methamphetamine use among young Iranian adults is concerning. Educational settings should be equipped with the required resources to take a proactive role in educating adolescents and young adults on substance use including methamphetamine.Scientific SignificanceThis study was done on a national level and identified the factors that can correlate with methamphetamine use. Its results can be very useful for policy decision makers. (Am J Addict 2017;XX:1–7)
       
  • Indirect effects of 12-session seeking safety on substance use outcomes:
           Overall and attendance class-specific effects
    • Abstract: ObjectivesThis study examined in- and post-treatment mediation effects of a 12-session dose of Seeking Safety (SS)—an integrative cognitive behavioral treatment for comorbid PTSD and SUDs—on alcohol and cocaine outcomes in comparison to Women's Health Education (WHE) in a seven-site randomized controlled effectiveness trial.MethodsWomen (n = 353) enrolled in outpatient substance abuse treatment, who had experienced multiple traumas in childhood and/or adulthood and who had comorbid PTSD, were randomly assigned to receive SS or WHE delivered in open enrollment groups for 12 sessions in 6 weeks (unlike the full 25-topic SS protocol). Data were analyzed under two forms of longitudinal mediation analysis, each accounting for changes over time in group membership and group context, respectively.ResultsWomen in SS, compared to WHE, showed significantly steeper decreases in PTSD frequency and severity, which in turn, showed significant impact in reducing both cocaine and alcohol use. This pattern was strongest for those who completed most of the treatment sessions, which was the majority of patients in the trial; these patterns only emerged during the in-treatment phase.ConclusionsUse of an integrated approach to PTSD/SUD such as SS can be helpful to more rapidly reduce PTSD, which consequently reduce SUD symptoms, particularly for those who attend most of the available treatment sessions.Scientific SignificanceThis is one of the first studies to illustrate such effects in treating comorbid PTSD and SUD in the context of a highly impaired population delivered by community-based providers. (Am J Addict 2013;XX:000–000)
       
  • Investigating the association between strategic and pathological gambling
           behaviors and substance use in youth: Could religious faith play a
           differential role'
    • Abstract: ObjectivesThis study investigated the link between gambling behaviors and the use of alcohol, drugs, and nonprescribed prescription medications, while exploring the moderating role of distinct religious faiths.MethodsIn 2010, 570 students from the American University of Beirut completed a self-reported, anonymous English questionnaire, which included lifetime gambling and past-year substance use measures.ResultsHalf (55%) were lifetime gamblers, of whom, 12% were probable pathological gamblers. About 60% were strategic gamblers. Lifetime gamblers were more than twice as likely as nongamblers to report past-year illegal drug use and alcohol abuse. Probable pathological gamblers were also more than four times as likely as nongamblers to report nonmedical prescription drug use, illegal drug use, and alcohol abuse. Compared to nonstrategic gamblers, strategic gamblers had more than three times the odds of illegal drug and cigarette use. The link between alcohol abuse and gambling was stronger among Christians than Muslims. Conversely, Muslims were more likely to report the co-occurrence of various gambling behaviors (lifetime, probable pathological, and strategic gambling) with both illegal drug use and cigarette use.ConclusionsGambling and substance use behaviors were strongly linked in this sample of youth from Lebanon, corroborating the evidence from North America. Particularly novel are the co-occurrence of pathological gambling and nonmedical prescription drug use and the potential differential role of religion. (Am J Addict 2013;XX:1–8)
       
  • Relationship between Motor Threshold and Externalizing Symptoms in
           Subjects at High Risk for Alcohol Dependence: A TMS Study
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           John Brick, PhD
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  • Special Issue on Diversity, Alcohol, and Genetics
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  • Commentary: Perspectives on alcohol-related gene and environment interplay
           in diverse populations
    • Abstract: Background and ObjectivesRacial/ethnic groups comprise more than 20% of the U.S. population, but many experience disproportionately high risk for alcohol misuse, often resulting in higher rates of alcohol-associated consequences. Completion of mapping the human genome has launched rapidly evolving research methods aimed at improved understanding of genetic contribution to disease. Despite decades of research on the influence of genetic and environmental risks on alcohol use disorders and outcomes, few studies have included racial/ethnic subpopulations in sufficient numbers to allow for proper statistical analysis.MethodsThe papers in this special issue help to elucidate current knowledge on the etiology of genetic and environmental contributors and potential moderators of alcohol use and associated problems among racial/ethnic populations. The lack of racial/ethnic diversity across many genetic studies contributes to challenges in interpretation of findings and eventually applications to precision medicine.ResultsProposed approaches to overcome disparities in racial/ethnic participant recruitment in genetic studies include methods to address population stratification in allele frequency, improve transparency in subjects’ consenting to participate, and engaging interdisciplinary research teams and community involvement to improve recruitment of racial/ethnic minorities.Discussion and ConclusionsThe reviews presented underscore various gaps in our knowledge of the genetic influences on alcohol use disorders due to the failure to include racially and ethnically diverse populations in genetic and epigenetic study samples. New directions are suggested to overcome the resulting research challenges and ultimately to inform future personalized intervention approaches for racial/ethnic populations.Scientific SignificanceInclusion of heterogeneous populations in genomic research will provide a better comprehension of possible unique genetic factors in the broader general population that may be missed due to exclusion of unique and common variants that may be present in racial/ethnic populations. (Am J Addict 2017;26:526–531)
       
  • Conclusion: Special issue on genetic and alcohol use disorder research
           with diverse racial/ethnic groups: Key findings and potential next steps
    • Abstract: Background and ObjectivesThis special issue brings together papers focusing on a wide range of topics relevant to the research and understanding of the role of race/ethnicity and genetic variation for the susceptibility of developing an alcohol use disorder (AUD).MethodsThe key findings from the issue's 10 articles are reviewed and organized here around three topics: I: addictive behaviors and potential environmental influences; II: a focus on four racial/ethnic groups; and III: special methodologies.ResultsSeveral potential next steps in improving effective research strategies are highlighted: (1) implementing best practices for outreach and community engagement may reduce reluctance to participate; (2) recruiting adequately sized and racially/ethnically diverse samples will require new collaborations with investigators who successfully work in diverse communities; (3) identifying and assessing environmental influences that are both unique to, and common among, racial/ethnic groups may inform preventions for AUD; (4) use of standardized measures will facilitate the generation of larger samples and meta-analysis of research findings; and (5) use of better analytic approaches and experimental methods will improve replication in gene finding research and help advance new areas of research.ConclusionsGenetic research of AUD in diverse racial/ethnic populations is advancing. The articles in this issue examined the general theme of including diverse population groups in genetic studies and offered potential strategies for addressing some common problems.Scientific SignificanceGreater inclusion of diverse racial/ethnic populations in this research is important to ensure that the benefits of new knowledge and technology are equally shared. (Am J Addict 2017;26:532–537)
       
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  • The utility of empirically assigning ancestry groups in cross-population
           genetic studies of addiction
    • Abstract: Background and ObjectivesGiven moderate heritability and significant heterogeneity among addiction phenotypes, successful genome-wide association studies (GWAS) are expected to need very large samples. As sample sizes grow, so can genetic diversity leading to challenges in analyzing these data. Methods for empirically assigning individuals to genetically informed ancestry groups are needed.MethodsWe describe a strategy for empirically assigning ancestry groups in ethnically diverse GWAS data including extensions of principal component analysis (PCA) and population matching through minimum Mahalanobis distance. We apply these methods to data from Spit for Science (S4S): the University Student Survey, a study following college students longitudinally that includes genetic and environmental data on substance use and mental health (n = 7,603).ResultsThe genetic-based population assignments for S4S were 48.7% European, 22.5% African, 10.4% Americas, 9.2% East Asian, and 9.2% South Asian descent. Self-reported census categories “More than one race” and “Unknown”as well as “Hawaiian/Pacific Islander” and “American-Indian/Native Alaskan” were empirically assigned representing a +9% sample retention over conventional methods. Although there was high concordance between self-reported race and empirical population-match (+.924), there was reduction in variance for most ancestry PCs for genetic-based population assignments.ConclusionsWe were able to create more genetically homogenous groups and reduce sample and marker loss through cross-ancestry meta-analysis, potentially increasing power to detect etiologically relevant variation. Our approach provides a framework for empirically assigning genetic ancestry groups which can be applied to other ethnically diverse genetic studies.Scientific SignificanceGiven the important public health impact and demonstrable gains in statistical power from studying diverse populations, empirically sound practices for genetic studies are needed. (Am J Addict 2017;XX:1–8)
       
  • Testing the nicotine dependence measure mFTQ for adolescent smokers: A
           multinational investigation
    • Abstract: Background and ObjectivesAs a measure of nicotine dependence among adolescent smokers, the modified Fagerström Tolerance Questionnaire (mFTQ; seven items), has been successfully used in the United States (USA). Nonetheless, the validity and reliability of mFTQ at the international level is still needed. The current study is the first to test the validity and reliability of mFTQ in four countries: Thailand, Spain, the USA, and Russia.MethodsIn a cross-sectional survey, mFTQ, risk factors of nicotine dependence, and sociodemographic characteristics were assessed. Risk factors included age of first cigarette, frequency of alcohol use, frequency of marijuana use, and number of cigarettes smoked yesterday. Salivary cotinine was also obtained in Thailand and Spain.ResultsFor all four countries, mFTQ exhibited a single factor structure, as supported by previous work in the USA. For all studied countries except Thailand, mFTQ presented acceptable internal reliability. Overall, risk factors of nicotine dependence have predicted mFTQ scores across countries. Frequency of alcohol use in the USA and frequency of marijuana use in Thailand and Spain were not associated with mFTQ scores.Discussion and ConclusionsmFTQ is a single-factor measure of nicotine dependence that shows acceptable internal consistency and validity across countries. Further work can advance the scale and tailor it to different cultures.Scientific SignificancemFTQ can be a clinically practical international measure of nicotine dependence. This study provides initial support for the utility of the mFTQ among Thai, Spanish, American, and Russian adolescents. Further research is needed to test and advance mFTQ across cultures. (Am J Addict 2017;XX:1–8)
       
  • Factors associated with attrition rate in a supportive care service for
           substance using pregnant women in Brazil
    • Abstract: Background and ObjectivesRetaining substance using women in antenatal care remains a major challenge. This study explored factors associated with attrition rate among women with substance use problems attending a supportive care service during pregnancy and soon after the birth of the infant.MethodsRecords of 166 women's antenatal consultations were analyzed.ResultsAttrition rate was high (75/166, 45.2%), and was associated with women having no schooling/primary schooling only, no family contact, having child(ren), crack-cocaine use, poly drug use, and substance use problems by the expected child's father.Discussion and ConclusionsAttrition may be the outcome of socio-demographic, family, individual, and substance use issues not fully addressed in prenatal interventions.Scientific SignificanceIdentification of who are at risk for dropping out affords services with an opportunity to prevent its occurrence. (Am J Addict 2017;XX:1–4)
       
  • Prevalence and predictors of substance use disorders among homeless women
           seeking primary care: An 11 site survey
    • Abstract: Background and ObjectivesHomeless women have shown high rates of substance use disorders (SUD), but many studies are more than a decade old, limited in geographic location, or focus only on women living outdoors or in shelters. The purpose of this study was to obtain a more current and representative sample of homeless women and the prevalence and predictors of substance use disorders among women seeking primary care at Health Care for the Homeless clinics across the US.MethodsEleven Health Care for the Homeless (HCH) clinics in nine states contributed proportionally to a sample of n = 780 female patients who completed a self-administered survey including demographics, housing history, health, mental health, and drug and alcohol use.ResultsCompared to the general population of women, rates were four times higher for an alcohol use disorder, and 12 times higher for a drug use disorder.Discussion and ConclusionsThe findings indicate a significant need for SUD services, with an equally high need for mental health services. In addition, high rates of victimization and use of tobacco, and overall poor health status, indicate overall health disparities.Scientific SignificanceAddressing barriers to full integration of substance use and mental health services, such as improving screening, reimbursement, clinician training, and addressing biases about motivation of this population to engage in treatment, are necessary to improve the health of women seeking care in HCH settings. (Am J Addict 2017;XX:1–9)
       
  • Management of mood and anxiety disorders in patients receiving opioid
           agonist therapy: Review and meta-analysis
    • Abstract: Background and ObjectivesPatients with opioid use disorders and mood and anxiety symptoms have a variable prognosis. Few randomized controlled trials (RCTs) have evaluated treatment of depression or anxiety in patients receiving opioid agonist therapies (OAT). This review evaluates studies of pharmacotherapy/psychotherapy for treating symptoms of depression or anxiety in patients receiving OAT.MethodsPublic databases were searched for clinical trials of pharmacotherapy or psychotherapy for managing depression or anxiety symptoms in adults receiving OAT. Subsequently, we conducted a random effects meta-analysis model of RCTs by antidepressants subclasses.ResultsIn our literature search, we identified 22 RCTs, eight of which were eligible for meta-analysis. Seven studies evaluated antidepressants in patients already maintained on OAT; two studies reported significant results for antidepressant effects versus placebo. Similarly, two of the seven studies that initiated antidepressants with OAT had advantages over placebo. Meta-analysis of grouped data revealed that tricyclic antidepressants (TCAs) (n = 235) significantly improved mean depression scores (SMD = −2.35, 95%CI: [−4.35, −0.34], z = −2.29, p = .022) while Selective Serotonin Reuptake Inhibitors (SSRIs) (n = 311) were not significantly different than placebo (SMD = 0.47, 95%CI: [−0.35, 1.30], z = 1.12, p = .263). Four out of five studies that implemented psychotherapeutic approaches reported a greater reduction of depressive symptoms than the comparison group. (Am J Addict 2017;XX:XX–XX)Conclusions and Scientific SignificanceTo date, psychotherapy has the most documented evidence for efficacy. TCAs appears effective but with more adverse effects than SSRIs. Further studies of OAT and adjunct antidepressant treatments for dual diagnosis patients are warranted. (Am J Addict 2017;XX:1-13)
       
  • Introduction to the special issue on genetic research of alcohol use
           disorderin diverse racial/ethnic populations
    • Abstract: This special issue of The American Journal on Addictions is an extension of a workshop held at the Research Society on Alcoholism (2015) highlighting several important issues related to studies of the genetic bases of alcohol use disorder among racially/ethnically diverse populations. While not exhaustive in their coverage, the papers in this special issue focus on three important topics: (1) the importance of considering the social and environmental context in genetic analyses; (2) social and cultural considerations for engaging diverse communities in genetic research; and (3) methodologies related to phenotype development for use with racially/ethnically diverse populations. A brief overview of each paper included in these three sections is presented. The issue concludes with additional considerations for genetic research with racially/ethnically diverse population groups along with a commentary. (Am J Addict 2017;XX:1–2)
       
  • Can a rapid measure of self-exposure to drugs of abuse provide dimensional
           information on depression comorbidity'
    • Abstract: Background and ObjectivesAddictions to heroin or to cocaine are associated with substantial psychiatric comorbidity, including depression. Poly-drug self-exposure (eg, to heroin, cocaine, cannabis, or alcohol) is also common, and may further affect depression comorbidity.MethodsThis case-control study examined the relationship of exposure to the above drugs and depression comorbidity. Participants were recruited from methadone maintenance clinics, and from the community. Adult male and female participants (n = 1,201) were ascertained consecutively by experienced licensed clinicians. The instruments used were the SCID-I, and Kreek-McHugh-Schluger-Kellogg (KMSK) scales, which provide a rapid dimensional measure of maximal lifetime self-exposure to each of the above drugs. This measure ranges from no exposure to high unit dose, high frequency, and long duration of exposure.ResultsA multiple logistic regression with stepwise variable selection revealed that increasing exposure to heroin or to cocaine was associated greater odds of depression, with all cases and controls combined. In cases with an opioid dependence diagnosis, increasing cocaine exposure was associated with a further increase in odds of depression. However, in cases with a cocaine dependence diagnosis, increasing exposure to either cannabis or alcohol, as well as heroin, was associated with a further increase in odds of depression.Discussion and ConclusionsThis dimensional analysis of exposure to specific drugs provides insights on depression comorbidity with addictive diseases, and the impact of poly-drug exposure.Scientific SignificanceA rapid analysis of exposure to drugs of abuse reveals how specific patterns of drug and poly-drug exposure are associated with increasing odds of depression. This approach detected quantitatively how different patterns of poly-drug exposure can result in increased odds of depression comorbidity, in cases diagnosed with opioid versus cocaine dependence. (Am J Addict 2017;XX:1–8)
       
  • Comparing triggers to visual disturbances among individuals with positive
           vs negative experiences of hallucinogen-persisting perception disorder
           (HPPD) following LSD use
    • Abstract: Background and OjectiveExploring differences in visual disturbances and triggers between Hallucinogen-Persisting-Perceptual-Disorder (HPPD) Type I (“positive/benign”) and II (“negative/distressing”).MethodsForty individuals with HPPD and prior LSD use completed clinical questionnaires.ResultsThe most common type of visual disturbances among individuals with HPPD I and II was slow movement of still objects and trailing phenomena, respectively. Those with HPPD I were more likely to report experiencing disturbances in dark environment, while looking at a still or moving object and during sexual intercourse.Discussion And ConclusionsHPPD I and II differ in terms of visual disturbances and triggers, possibly representing different phenomena existing on the same spectrum.Scientific SignificanceOur study indicating differences in triggers to HPPD I and II adds to existing literature on differences in visual disturbances between the two subtypes. Further research elucidating additional differences between the subtypes of HPPD is needed. (Am J Addict 2017;XX:1–4)
       
  • Genetic and psychosocial predictors of alcohol use trajectories among
           disaster-exposed adolescents
    • Abstract: Background and ObjectivesAdolescent alcohol misuse is associated with numerous long-term adverse outcomes, so we examined predictors of alcohol use among disaster-exposed adolescents, a group at-risk for alcohol misuse.MethodsThe current study (n = 332) examined severity of tornado-related exposure, posttraumatic stress disorder (PTSD) symptoms, emotional support, and a genetic risk sum score (GRSS) as predictors of alcohol use trajectories.ResultsSeverity of exposure interacted with the GRSS to predict both intercept (12-month follow up quantity of alcohol use) and growth rate. Emotional support also interacted with adolescent PTSD symptoms to predict intercept and growth rate.Discussion and ConclusionsAdolescents with greater severity of disaster exposure and high genetic risk comprise a high risk group, on which efforts to prevent alcohol use should be focused. Additionally, emotional support is essential in buffering the effects of PTSD symptoms on alcohol use outcomes among adolescents.Scientific SignificanceToward the aim of reducing adolescent alcohol misuse following disaster exposure, there is utility in inserting immediate supports (e.g., basic resources) into communities/families that have experienced significant disaster-related severity, particularly among adolescents at high levels of genetic risk for alcohol use/misuse. Additionally, prevention efforts aimed at improving emotional supports for adolescents with more PTSD symptoms may reduce propensity for alcohol misuse following disaster. This information can be easily incorporated into existing web-based interventions. (Am J Addict 2017;XX:1–9)
       
  • Emotion dysregulation as a mechanism linking anxiety and hazardous
           drinking among Latinos in primary care
    • Abstract: Background and ObjectivesResearch suggests that Latinos experience significantly more mental health and alcohol use problems than non-Latino whites. However, relatively little is known about the mechanisms underlying alcohol use in this population. One factor associated with excessive alcohol use in Latinos is anxiety. A potential explanatory mechanism for this relationship is emotion dysregulation, as emotion dysregulation in the context of anxiety may lead to alcohol use problems/disorders. The aim of the current study was to examine the indirect effect of anxiety, through emotion dysregulation, on drinking severity and probable hazardous drinking in Latinos.MethodsLatino adults (N = 264) were recruited from a primary care health clinic as part of a larger ongoing study examining mental health among Latinos in primary care. Participants were interviewed using the MINI and then completed various self-report assessments (in Spanish). Structural equation modeling was used to evaluate model fit.ResultsStructural models fit the data well. Additionally, there were statistically significant indirect effects of anxiety via emotion dysregulation on drinking severity and probable screen for hazardous drinking.Discussion and ConclusionsAnxiety may contribute to alcohol use problems due to an overall tendency to engage in maladaptive attempts to regulate emotions.Scientific SignificanceTargeting emotion dysregulation in the context of anxiety and hazardous alcohol use among Latinos may be one therapeutic strategy to reduce severity of alcohol use (and hazardous drinking). (Am J Addict 2017;XX:1–8)
       
  • Integrated care pathway for co-occurring major depressive and alcohol use
           disorders: Outcomes of the first two years
    • Abstract: BackgroundMajor Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) are highly prevalent, comorbid, and have significant impact on morbidity, mortality, and socioeconomic burden in Canada. Combined psycho- and pharmacotherapies for both conditions promise better outcomes than treatment as usual (TAU). At the Centre for Addiction and Mental Health, Toronto, Canada, we developed and implemented an Integrated Care Pathway (ICP) specifically for treatment of concurrent MDD and AUD. The goal of the study is to assess the clinical effectiveness of the ICP approach in comparison to TAU.Materials and MethodsNon-randomized design, clinical chart review, Chi-square and t-tests, Cohen's d, Linear Mixed Effects Models, Kaplan–Meier, and log-rank analyses.ResultsEighty-one ICP patients were included, matched to 81 controls by age, sex, severity of depressive symptoms, and patterns of drinking. ICP cohort had a significantly lower dropout rate (18.5% vs 69.1%, p 
       
  • Screening for adult attention deficit/hyperactivity disorder in high-dose
           benzodiazepine dependent patients
    • Abstract: Background and ObjectivesAdult attention-deficit/hyperactivity disorder (ADHD) is frequent in patients with substance use disorders (SUD), but information on its prevalence in high-dose benzodiazepine (BZD) dependence is lacking. We estimated the prevalence of adult ADHD in a group of treatment-seeking high-dose BZD dependent patients according to a valid screening tool, and explored the demographic and clinical characteristics of patients that screened positive for ADHD (ADHD+) in comparison to those that screened negative (ADHD−).MethodsWe prospectively recruited 167 consecutive patients with high-dose BZD dependence and screened them for adult ADHD with the World Health Organization Adult ADHD Self-Report Scale version 1.1 (ASRS-v1.1) Symptom Checklist Part A. We compared demographic and clinical characteristics in ADHD+ and ADHD− groups.ResultsFifty-three patients (31.7% of the sample) were positive to adult ADHD screening. ADHD+ patients showed a significantly larger prevalence of poly-drug abuse than ADHD− ones. BZD formulation and active principle significantly differed between the two groups. The other clinical variables, including psychiatric comorbidity, as well as the demographic ones, did not differ in ADHD+ versus ADHD− comparison.Discussion and ConclusionsAdult ADHD may be common in treatment-seeking high-dose BZD dependent patients according to ASRS-v1.1 Symptom Checklist Part A.Scientific SignificanceScreening for ADHD in this type of SUD with this questionnaire is quick and may offer useful information for prognosis and treatment. (Am J Addict 2017;XX:1–5)
       
  • An association between genetic variation in the glutamatergic system and
           suicide attempts in alcohol-dependent individuals
    • Abstract: Background and ObjectivesPathological alterations of glutamatergic systems were observed in neurodegenerative and psychiatric disorders. There is some evidence that this system may be involved in the genetic vulnerability to suicide. The aim of the present study was to analyze possible relationship between the GRIN2B polymorphism and suicidal behavior. We hypothesized that this genetic factor may be associated with suicide attempts in alcohol-dependent patients and with death by suicide.MethodsTo analyze the relationship between GRIN2B and suicide attempts, the selected rs2268115 polymorphism was genotyped in a sample of 345 alcohol-dependent individuals stratified by the history of suicide attempts. The second part of the study concerning suicide was based on a sample of 510 suicide victims and 450 controls.ResultsThe frequency of rs2268115 G allele among alcohol-dependent patients with the history of suicide attempts was significantly higher than among non-suicidal alcohol-dependent individuals (OR = 1.45, p = .033). This association was more significant when analyzing alcohol-dependent patients only without co-occurring drug dependence (OR = 1.62, p = .021). The analyzed GRIN2B polymorphism was associated with a twofold increase in odds of a suicide attempt (OR = 2.01, p = .004). No relationships between rs2268115 and death by suicide were identified.Discussion and ConclusionsOur results suggest that glutamatergic system influence susceptibility to suicide attempts in alcohol-dependent individuals. Suicidal behavior and alcohol dependence may share a common etiology related to the glutamatergic system.Scientific SignificanceThe major contribution of the present study is a novel finding of the possible association between GRIN2B rs2268115 polymorphism and suicide attempts in alcohol-dependent individuals. (Am J Addict 2017;XX:1–7)
       
  • Three-year retention in buprenorphine treatment for opioid use disorder
           nationally in the Veterans Health Administration
    • Abstract: BackgroundBuprenorphine has become the major treatment for opioid use disorder (OUD) but data on long treatment term retention and its correlates are sparse.MethodsAll veterans with OUD treated in Veterans Health Administration (VHA) facilities nationally in fiscal year (FY) 2012, and who began treatment with buprenorphine as indicated by a first prescription after the first 60 days of the year were identified with the date of and their last prescription from FY 2012–2015. Veterans were classified into four groups based on time from first to last prescription: (0–30 days, 31–365 days; 1–3 years; and more than 3 years). These groups were compared on socio-demographic, diagnoses and service, and psychotropic drug use. Kaplan-Meier curves and Cox proportional hazards models were used to identify variables independently associated with retention in buprenorphine treatment.ResultsVeterans newly started on buprenorphine (n = 3,151) were retained in treatment for a mean duration of 1.68 years (standard deviation [SD] 1.23), with 61.60% (n = 1,941) retained for more than a year and 31.83% (n = 1,003) for more than 3 years. Cox proportion hazards model showed that only black race (Hazards ratio [HR] 1.26; standard error [SE] .06; p.0003), the Charlson index (HR 1.03; SE .01; p.0132) and emergency room visits during FY 2012 (HR 1.03; SE .01; p 
       
 
 
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